[20M] With numbness in pinky, chest pain, and other symptoms

Patient Description

A 20-year-old male presents with constant numbness in the pinky, extending to parts of the palm and ring finger. The numbness feels like pins and needles, with only pressure being sensed, not texture. Additionally, the patient reports sporadic chest pain that feels like something is stuck in the middle of the chest, rated 4 out of 10 in severity. Deep breathing seems to help relax the pain but causes blurred vision and disorientation, affecting depth perception and making colors seem more vibrant. The blurred vision and disorientation occur only with the chest pain. The patient also experiences shortness of breath with the chest pain, fatigue, and occasional abdominal discomfort. There is no recent head injury or trauma, and no weakness or paralysis in other parts of the body except for the numb pinky, which responds weaker than other fingers. The patient has a family history of heart attacks among males and has ADHD. He also experiences moderate to severe back pain that started 4-5 years ago and has a skin allergy to mosquitoes. The patient is not currently taking any medications but reports occasional indigestion in the morning, which is relieved by Tums within an hour.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  1. Ulnar Nerve Compression (Cubital Tunnel Syndrome):

    • Rationale: Numbness in the pinky and ring finger, extending to parts of the palm, is often associated with compression of the ulnar nerve, which runs along the inner side of the elbow.
    • Treatment: Treatment may involve avoiding activities that exacerbate the symptoms, wearing a splint, physical therapy, and in some cases, surgery.
  2. Gastroesophageal Reflux Disease (GERD):

    • Rationale: Sporadic chest pain, indigestion, and a sensation of something stuck in the chest can be symptoms of GERD.
    • Treatment: Lifestyle changes such as avoiding trigger foods, eating smaller meals, and not lying down after eating. Over-the-counter antacids like Tums can help, but persistent symptoms may require prescription medications.
  3. Cardiac Issues:

    • Rationale: Given your family history of heart attacks and the presence of chest pain and shortness of breath, it is important to rule out cardiac issues.
    • Treatment: Immediate medical evaluation is crucial to rule out serious conditions such as angina or a heart attack. This may involve an electrocardiogram (ECG), blood tests, and possibly imaging studies.
  4. Anxiety or Panic Attacks:

    • Rationale: Sporadic chest pain, shortness of breath, blurred vision, and disorientation can sometimes be symptoms of anxiety or panic attacks.
    • Treatment: Stress management techniques, counseling, and medications can help manage anxiety.

What you can do

  1. Seek Medical Attention: Given the combination of symptoms, especially the chest pain and family history of heart attacks, it is important to see a healthcare provider as soon as possible for a thorough evaluation.
  2. Avoid Aggravating Activities: For the numbness in your pinky, try to avoid activities that put pressure on your elbow or wrist. Using an ergonomic keyboard and mouse setup may help if you spend a lot of time on the computer.
  3. Lifestyle Modifications: For potential GERD, avoid eating large meals, spicy foods, and lying down immediately after eating. Elevate the head of your bed if nighttime symptoms are an issue.
  4. Stay Hydrated and Rested: Ensure you are getting enough rest and staying hydrated, which can help with overall well-being and potentially reduce some of your symptoms.

What you should look out for

  • Worsening Chest Pain: If your chest pain becomes severe, lasts longer, or is accompanied by other symptoms like sweating, nausea, or pain radiating to your arm or jaw, seek emergency medical attention immediately.
  • Increased Numbness or Weakness: If the numbness in your pinky spreads or you experience significant weakness, see a healthcare provider promptly.
  • Persistent or Severe Symptoms: If your symptoms do not improve with initial treatments or if they worsen, consult a healthcare provider for further evaluation.

Remember, this information is not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and appropriate treatment.

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7 mo ago

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People Also Ask


What causes numbness in the pinky and ring finger?

Numbness in the pinky and ring finger is often caused by ulnar nerve compression, also known as Cubital Tunnel Syndrome. This occurs when the ulnar nerve, which runs along the inner side of the elbow, is compressed or irritated.


Can GERD cause chest pain and how can it be managed?

Yes, GERD can cause chest pain, often described as a burning sensation or discomfort in the chest. It can be managed by avoiding trigger foods, eating smaller meals, not lying down after eating, and using over-the-counter antacids. Persistent symptoms may require prescription medications.


How can I differentiate between anxiety-related symptoms and cardiac issues?

Anxiety-related symptoms can include chest pain, shortness of breath, blurred vision, and disorientation, similar to cardiac issues. However, cardiac issues often present with additional symptoms like pain radiating to the arm or jaw, sweating, and nausea. It's important to seek medical evaluation to rule out serious conditions.


What lifestyle changes can help manage symptoms of GERD?

To manage GERD symptoms, avoid large meals and spicy foods, do not lie down immediately after eating, and elevate the head of your bed if you experience nighttime symptoms. These lifestyle changes can help reduce the frequency and severity of GERD symptoms.


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